Health Coverage For Children Still Fragmented -- December 19, 2003 -- California Capitol Hill Bulletin -- Volume 10, Bulletin 37

While California's rate of uninsured children has dropped by one-third in the past ten years, 14.3 percent of children statewide (one in seven) remain uninsured, found a new study released by Children Now. Titled "California Report Card 2003", the report focuses on infant health, health insurance and access to care, oral and mental health, nutrition and physical fitness. It was based on state and federal statistics and UCLA's 2001 California Health Interview Survey of more than 50,000 respondents.

The report found wide differences in health coverage for children in different counties. Solano county has the lowest rate of uninsured children with 4.3 percent, while Santa Barbara County has the highest number, with almost one in five children lacking health coverage (19 percent). Santa Barbara County, along with San Diego and Riverside, also ranked lowest in children's medical and dental coverage and prenatal care, while Alameda, San Francisco, and Sacramento, placed in the top 10 in these indicators. Overall, California ranks 45th out of the 50 states with 1.3 million children without health insurance. The report finds, however, that the number of uninsured children in the state could be reduced by two-thirds if all children eligible for public insurance programs like Medi-Cal and Healthy Families were enrolled.

The report also found that children's health coverage diverged along ethnic lines. Among those that are uninsured, Korean-American and Latino children have the highest uninsured rate, with 32.8 percent and 24 percent, respectively, lacking health care coverage. In comparison, 5.8 percent of Chinese-American children lack coverage, as do 16.8 percent of Native-American children, 9.1 percent of Asian children, 8.2 percent of white children, and 6.1 percent of African-American children. The report offers several probable underlying reasons to explain such differences in coverage for different ethnic groups, including high instances of self-employment in the Korean-American community, and fear that enrolling their children in health programs will place their immigration status in danger on the part of some Latino and Asian families.

In addition, the report looks at the prevalence of asthma in the state. It found that in California, 1.2 million children (13.6 percent) have been diagnosed with the illness, compared with a national average of 7.3 percent. Siskiyou, Lassen and Trinity counties have some of the lowest asthma rates in the state (9.5 percent each), while Fresno (21 percent) and Solano (21.3 percent) have some of the highest. African-American (22.1 percent) and Native American (26.8 percent) children tend to be diagnosed with asthma at higher rates than Latino (10.3 percent), Asian-American (12.5 percent) and white (15 percent) children. Similar results were published by the UCLA Center for Health Policy Research, which reported that 9.6 percent of California's children and 8.5 percent of its adults are diagnosed with asthma.

The study found that more than a third (34 percent) of low-income parents find it consistently hard to provide food for their children, while just a quarter of California's children meet state standards for physical fitness. The report concludes by making several recommendations to improve children's health in California, including improving delivery of nutrition programs for low-income children, expanding access to fluoridated water to prevent dental decay, ensuring children get daily physical exercise, and developing an electronic system to enroll children in state health programs at birth and in schools.

To get more information about this report, please visit the Children Now website at: http://www.childrennow.org/publications.cfm .

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